hetrombopag + ripertamab + venetoclax

This is a combination therapy consisting of three agents: - **Hetrombopag** is an oral thrombopoietin receptor agonist (TPO-RA) that stimulates platelet production and is used primarily for the treatment of immune thrombocytopenia (ITP) and chemotherapy-induced thrombocytopenia[4][7][9]. - **Ripertamab** is a monoclonal antibody targeting CD20, functioning as an anti-CD20 immunotherapy, similar in mechanism to rituximab. It depletes B cells by binding to the CD20 antigen on their surface[1][5]. - **Venetoclax** is a small molecule inhibitor of B-cell lymphoma 2 (BCL2), promoting apoptosis in malignant hematologic cells. It is approved for use in chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and other hematological malignancies[1][2]. The combination has been reported in case literature as a therapeutic strategy for patients with chronic myelomonocytic leukemia (CMML) complicated by immune thrombocytopenia, where standard therapies may be insufficient. The rationale behind this regimen leverages the synergistic effects of targeted B-cell depletion, induction of apoptosis in malignant cells, and stimulation of platelet production[1].